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Contract Details
Facility name
Thuss Medical Center
Provider ID
P000002474
NPI
1962533414
Tax ID
631228071
Effective Date
12/1/2003
Last Updated
9/11/2013
Direct Contract
Yes
Term Date
1/1/2008
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2124 4th Avenue South
Birmingham, AL 35233
United States
County
Jefferson
Phone
2059458185
(
Phone
)
Billing Details
Address
Specialty Type
General Practice
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Address